The Natural History and Treatment of Prostatitis

Prostatitis is a term used by different clinicians to mean different things. The pathologist uses the term to describe inflammatory changes seen under the microscope whereas the clinician applies the term to a set of symptoms which may or may not relate to inflammation. These differences in meaning further confuse an imprecise clinical picture. The symptoms and clinical signs of acute prostatitis usually include several of the following features: fever, malaise, rigors, urinary frequency, dysuria, pain in the groin or perineum or tenesmus. Symptoms of chronic prostatitis include perianal discomfort, an aching sensation on the inner aspects of the thighs, suprapubic or deep perineal discomfort. In addition, there are often urinary frequency and dysuria, and there may be yellow or brown discolouration of the semen. Four conditions have been described which may produce some or all of these symptoms: prostatodynia, acute bacterial prostatitis, and chronic prostatitis, which may be either bacterial or nonbacterial.